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Full text of "Memorial soliciting a state hospital for the protection and cure of the insane : submitted to the General Assembly of North Carolina, November, 1848"

■Memorial Soliciting a State 
[Hospital 



THE LIBRARY OF THE 

UNIVERSITY OF 

NORTH CAROLINA 




FROM THE LIBRARY OF 

ALEXANDER B. ANDREWS 

Class of 1893 

TRUSTEE OF THE UNIVERSITY 

FRIEND OF THE LIBRARY 



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[HOUSE OF COMMONS DOCUMENT, NO, 2/f' 



MEMORIAL 



toLiciTrsa a 



STATE HOSPITAL 

FOR THE PROTECTION AND CURE OF THE INSANE, 



SUBMITTED TO THE 



GENERAL ASSEMBLY OP NORTH CAROLINA, 



lOVEIVBEB, 1848 



RALEIGH s 

3EATQN GALES, PRINTER FOR THE STATE, 



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MEMORIAL. 



To the General Assembly of the 

State of North Carolina : 

Gentlemen : — 

I respectfully ask your attention to the subject 
herein presented and discussed ; and solicit your prompt 
and favorable action upon the same. 

I come not to urge personal claims, nor to seek indi- 
vidual benefits ; I appear as the advocate of those who 
cannot plead their own cause ; I come as the friend of 
those who are deserted, oppressed, and desolate. In 
the Providence of God, 1 am the voice of the maniac 
whose piercing cries from the dreary dungeons of your 
jails penetrate not your Halls of Legislation. I am the 
Hope of the poor crazed beings who pine in the cells, and 
stalls, and cages, and waste rooms of vour poor-houses. 
I am the Revelation of hundreds of wailing, suffering 
creatures, hidden in your private dwellings, and in pens 
and cabins — shut out, cut off from all healing influences, 
from all mind-restoring cares. 

Could the sighs, and moans, and shrieks of the insane 
throughout your wide-extending land reach you here and 
now, how would your sensibilities to the miseries of these 
unfortunates be quickened ; how eager would you be to 
devise schemes for their relief — plans for their restoration 
to the blessing of a right exercise of the reasoning facul- 
ties. Could their melancholy histories be spread before 
you as revealed to my grieved spirit during the last three 
months, how promptly, how earnestly would you Eearoh 



out the most approved means of relief; how trifling, how 
insignificant, by comparison, would appear the sacrifices 
you are asked to make ; how would a few dimes and. 
dollars, gathered from each citizen, diminish in value as 
a possession, compared with the certain benefits and vast 
good to be secured for the suffering insane, and for their 
afflicted kindred, by the consecration and application of 
a sufficient fund to the construction of a suitable hospital 
in which the restoring cares of skilfully applied physical 
and moral treatment should be received, and in which 
humane and healing influences should take the place of 
abuse and neglect ; and of galling chains and loathsome 
dungeons. 

North Carolina, hailed of her sons, " the glorious Old 
North," — North Carolina, unburlhe ned by State debts, 
untouched by serious misfortunes, is last and latest of 
the "old thirteen," save the small terrirory of Dela- 
ware, to make provision for the care and cure of her 
insane citizens, and almost the last embracing all tho 
New States in our broad Union. 

But it is not to the State pride of the intelligent citi- 
zens, of North Carolina that my appeal comes ; it is to 
the liberal and humane hearts of this portion of my 
fellow citizens, its plea reaches ; it cannot be rejected, it 
dares not consent to be put off. it claims with earnest 
importunity that its merits may be discussed, it would 
merge in oblivion the multiplied miseries resulting from 
past neglects and procrastination, by wakening to action 
the efficient energies of humanity and justice. 

At present there are practiced in the State of North 
Carolina, four methods of disposing of her more than one 
thousand insane, epileptic, and idiot citizens, viz : In the 
cells and dungeons of the County jails, in comfortless 
rooms and cages in the county poor-houses, in the dwell- 
ings of private families, and by sending the patients to 
distant hospitals, more seasonably established in sister 
States. I ask to represent some of the very serious evils 
and disadvantages of each and all these methods of dis- 



posing of the insane, whether belonging to the poor or ts 
the opulent classes of citizens. 

It may be here stated that, by far the larger portion of 
the insane, epileptics, and idiots, are detained in or near 
private families, few by comparison, being sent to North- 
ern or Southern State hospitals, and yet fewer detained 
in prisons and poor-houses, yet so many in these last, and 
so melancholy their condition, that were the survey ta- 
ken of these cases alone, no stronger arguments would 
be needed to incite energetic measures for establishing 
an institution in North Carolina adapted to their neces- 
sities, and to the wants of the continually recurring 
cases which each year swell the record of unalleviated 
unmitigated miseries. 

If the plea of suffering humanity is insufficient to 
cmicken Legislative interposition, an argument based on 
indisputable evidence, may be advanced, whose force can- 
not be slighted ; I mean the economy, directly to individ* 
uals, towns, and counties, and remotely, but not less ac- 
tually to the State, of establishing without delay, a Hos- 
pital for the treatment and protection of the insane. 

In order precisely and definitely to present this subject 
in an economical point of view, 1 quote from carefully 
prepared tables furnished by the experienced Superinten- 
dant of one of the most successfully conducted Hospitals 
in the Union. The cases affording the following results 
are taken in their order of successive admission. The 
first twenty were the first incurable cases which were 
received at the institution : the last, those latest received. 
The expense of the first, cost before admission, one dollar 
and fifty cents per week. They had in the aggregate 
cost to the State each, one thousand five hundred and fifty 
dollars and fifty cents. On the other hand, the actual ex- 
pense of the last twenty cases which have been discharg- 
ed from the Hospital cured, amounts only to forty-seven 
dollars and a half each. Hence, it appears that the ex- 
penses already incurred for taking care of twenty cases 
suffered by delay and neglect, to become incurable, has 



6 

been more than thirty-lico times greater than the same 
number of cases for which early and proper provision 
had been made. The recent cases are well ; the old ones 
will doubtless continue a charge through life. Strange 
as it may appear, it is not the less true, that taking an 
average chance for cures, it would have been a pecuniary 
saving to the State to have had seasonable eare of these 
old cases, though at an expense of eighty dollars a week, 
rather than by neglect to have incurred the necessity of 
supporting them to the present time, and till their de- 
cease. 

The incarceration of insane men and women in Coun- 
ty prisons, whether furiously mad or otherwise, is object- 
ed to, first as subverting the uses for which these prisons 
are constructed, second, as placing the innocent on a 
level with the guilty, making misfortune and crime, dis- 
ease and health, go hand in hand. I said on a level, I 
mistake ; the felon looks forward to a period of enlarge- 
ment, and notes the time when his prison bonds shall be 
broken ; the insane whose imprisonment is aggravated 
and prolonged by consequence of sickness, not for his 
crimes, anticipates no season of liberty, no period of re- 
lease. 

Again, many persons adopt the idea that the insane are 
not sensible to external circumstances, that to their per- 
ceptions the dungeon, chains, cold, nakedness, and harsh 
epithets are as acceptable as a comfortable apartment, 
freedom from shackles, a pleasantly tempered atmos* 
phere, decent clothing, kindly speech, and a courteous 
address. They assert that coarse, ill-prepared food is as 
palatable as that which is wholesome and well cooked, 
that cold and heat, sunshine and cloud, pure air and that 
loaded with noisome exhalations, liberty and confine- 
ment are all one and the same to the insane, producing 
like impressions and results on the deranged intellect. 
Greater error of belief was never adopted ; more serious 
mistakes, and conducting to more fatal results could not 
be propagated. The insane in most cases full as acute- 
ly, and distinguish as readily as the sane. 



Nor are we to conclude that because a man is insane 
that he is not in a large majority of cases, able to ap- 
preciate the advantages of good associates, or that he is , 
obtuse under the contact of ill-chosen companionship. I 
recollect a gentleman who had enjoyed a liberal education, 
and possessed a refined mind, whobecame.insane and 
shortly furiously mad; for a little time he was conveyed 
to a jail, and exposed to the daily observation of a crowd 
of criminals, Avhose base language and coarse manners 
constantly exasperated his temper ; finally he was re- 
moved to a well ordered hospital, and after some months 
his recovery being complete, he was restored to his fam- 
ily and friends ; but he could not forgive them his deten- 
tion in the prison; he spoke with bitterness and severity 
on his having been subject to such a degradation. On 
the contrary, he dwelt with tender gratitude upon his sit- 
uation in the hospital, (that of Bloomingdale.War New 
York) and spoke with continual pleasure of the comforts 
which there surrounded him. But he never has relin- 
quished the opinion that his malady would have yielded 
much more promptly to the mental and moral treatment 
in that Institution, had he been at once conveyed thither. 
" I object absolutely, says Ellis, to the inhuman custom 
of confining insane persons and idiots in the same builds 
ings as prisoners and criminals ; the usage cannot be too 
strongly censured." Many examples might be adduced 
to illustrate the correctness of this position, and for other 
reasons than those already stated. 

In 1844, I found a furious madman in one of the dun- 
geons of the old jail in Fayette County. Perm. His disposi- 
tion was homicidal ; he had been in prison nearly fifteen 
years. On one occasion a m,in was brought into the 
prison intoxicated, having committed some offence while 
under the influence of ardent spirits ; he was thrown into 
the cell of the maniac, who it is supposed was provoked 
by him, but no one knows : this only is certain, he fell 
upon the involuntary intruder and murdered him in the 
excitement of a most ferocious temper. When the jailer 



8 

entered, a horrible spectacle presented itself, the murder- 
ed drunkard, mangled and lifeless, the insane muderer 
covered with gore, and exulting over the reeking remains 
of his victim ! 

In Philadelphia, some months since, the officers of the 
Moyamensing prison were roused from sleep by the cries of 
murder proceeding from a cell occupied by an insane man 
and a prisoner who had been committed for disorderly 
conduct. This unfortunate man was found lying upon 
the floor weltering in blood, while the murderer, in the 
highest state of phrenzy stood over him, brandishing a 
bloody knife. The head of the victim was nearly sever- 
ed from the body, and the body covered with frightful 
gashes. In reply to the enquiry what had led him to per- 
petrate this horrid deed, he answered that it was that he 
might not himself be killed. 

An insane man has for man}- years been confined in 
the jail at Germantown, Stokes County, in this State. 
On one occasion some time past, a negro prisoner was put 
into the same room as the crazy man; he did not like the 
companionship, and murdered him in a shocking manner, 
yet he seemed quite insensible to the turpitude of the 
deed, and rather exulted in the entire success of the act, 
as I was informed on a recent visit at the prison. 

I admit that public peace and security are seriously en- 
dangered by the non-restraint of the maniacal insane. I 
consider it in the highest degree improper that they 
should be allowed to range the towns and country with- 
out care or guidance ; but this does not justify the pub- 
lic in any State or community, under any circumstances 
or conditions, in committing the insane to prisons ; in a 
majority of cases the rich may be, or are sent to Hospitals ; 
the poor under the pressure of this calamity, have the 
same just claim upon the public treasury, as the rich have 
upon the private purse of their family ; as they have the 
need, so have they the right to share the benefits of Hos- 
pital treatment. Urgent cases at all times, demand, un- 
usual and ready expenditures in every community. 



9 

If County Jails ?nust be resorted to for security against 
the dangerous propensities of madmen, let such use of 
prison-rooms and dungeons be but temporary. It is not 
long since I noticed in a Newspaper, published near the 
borders of this State, the following paragraph: "It is our 
fate," writes the Editor, " to be located opposite the Coun- 
ty Jail, in which are now confined four miserable crea~ 
tures, bereft of the God-like attribute of reason : two of 
them females ; and our feelings are daily excited by 
sounds of woe, that would harrow up the hardest souL 
It is horrible that for the sake of a few thousand dollars 
the waitings of the wretched should be suffered to issue 
from the gloomy walls of our jails without pity and with* 
out relief. Were our law-makers doomed to listen for a 
single hour each day to the clanking of chains, and the 
piercing shrieks of these forlorn wretches, relief would 
surely follow, and the character of our State would be 
rescued from the foul blot that now dishonors it." In near- 
ly every jail in North Carolina, have the insane at dif- 
ferent times, and in periods varying in duration, been 
grievous sufferers. In Halifax County, several years 
since, a maniac was confined in the jail ; shut in the dun. 
geon, and chained there. The jail was set on fire by 
other prisoners : the keeper, as he told me, heard frantic 
shrieks and cries of the madman, and "might have saved 
him as well as not, but his noise was a common thing ; 
he was used to it, and thought nothing out of the way 
was the case." The alarm of fire was finally spread ; the 
jailer hastened to the prison: it was now too late; 
every effort, (and no exertions were spared,) to save the 
agonized creature, was unavailing. He perished in 
agony, and amidst tortures no pen can describe. 

In Wentworth, Rockingham County, is an aged crazy 
man whose history even carefully abridged would fill too 
many pages to be introduced here. The principal facts 
of his troubled life are known to many in all the adjoin- 
ing Counties. Can it be credited ? crazed and wretched, 
he has been the inmate of a prison for more than thirty 
years ! and that not for the commission of crimes, 



10 

In Stokes jail, at Germanton, was a very crazy man, 
confined in an unventilated, dreary dungeon. Being tol- 
erably quiet about that time, his chains had been re- 
moved, and he was rejoicing in being able to reach the 
low gratfd door, because, said he *'I can put my mouth 
close to the bars and draw in some air : dont you like 
fresh air," he enquired, " Oh it is so good"! " but oh is'nt 
it pleasant to look out and see the sky, and see the pretty 
fields; I cant see them here, now you are come to let me 
out; I know you have; I want to get out; I want to walk 
about; I don't want to stay here." Alas I could render 
no relief, the unfortunate man was incapable of self con- 
trol, and endangered life and property when at large, and 
there was no hospital to receive him in Carolina — he 
was poor, and so could not be conveyed to that of 
another State. 

I recollect, of many examples, one recorded in a 
Report to the Virginia Legislature, by Dr. Stribling, 
which serves to illustrate what might have been, in 
all probability, the benefits of timely Hospital care for 
theis suffering madman. 

In 1841, a patient was conveyed from a jail in 

County, where he had been confined loaded with irons for 
six months. He had been temperate and industrious, but 
was unfortunate and insanity ensued. He was convey- 
ed to the Hospital bound hand and foot, screaming vo- 
ciferously, and seeming a very demon in look and act. 
For days he was furious, but his malady yielded, at first 
by medical means, and finally by moral influences. In 
one month he was freed from all restraints, passed in 
and out of the building at pleasure, and soon cheerfully 
occupied himself upon the grounds of the Institution, in 
useful labor, without even an attendant. In four and a 
half months his cure was perfect, and he was discharged. 
His gratitude and attachment to his physician and nurse 
seemed unbounded. He returned to his home and set- 
tled his affairs there, and after a few months returned to 
offer his services as attendant in the Hospital, and has 
continued in the daily and hourly exercise of those kind 



11 

and humane cares which were so grateful and soothing 
in his own experience. He has the responsibility of 
guarding, protecting, employing, and amusing a class of 
fifteen patients, all of whom are devoted to him. Com- 
ment upon this case is needless. 

In the miserably dilapidated jail in Surry, was also a 
crazy man, quiet at the time of my visit, but subject to 
access of violent and alarming paroxysms. Before com- 
mittal he often declared to his wife that " he felt mighty 
strange, that he was bound to kill somebody, that he felt 
dreadfully, that he had a desire to kill her." He was 
not malicious, did not entertain emnity towards any one 
individual, but had a morbid and almost uncontrolla- 
ble desire " to see blood run." Of course, being looked 
upon as dangerous to the lives of others, he was com- 
mitted to the jail for an indefinite period, where the ap- 
plication of moral and medical means was unattainable. 
In a Hospital, he would have been an indn.strions and 
useful inmate, and probably in a short period might have 
been perfectl}' restored to mental and physical health. 

Since I was in Rowan, an insane man, possessed of a 
moderate fortune has been committed to the jail ; I will 
not attempt to depict his sufferings in the dismal dungeon 
into which he has been cast. 

From the comfortless, and old jail in Wilkes, an insane 
women had been discharged some time previously to my 
visit. At that period and since, I have received the fol- 
lowing facts of her history. Mrs. B- is now above 35 
years of age, and had for many years been eccentric, at 
last deranged, and finally has hecome a decided ma- 
niac. While her husband lived, he was ever kind and 
indulgent,. and often said to his neighbors, in excuse for 
her wayward conduct and ill-speech, that they must 
not mind her, for she was deranged, as he believed. 
More than a year since, she had been ill for sometime, 
her husband was exhausted from loss of sleep, and, as he 
thought at a favorable moment threw himself down to 
rest. She perceived him sleeping, she went out and re- 
turned with a large stone, with which she beat him upon 
the head so as to cause almost immediate death, Her 



12 

insanity was fully proved upon her trial, and she was 
remanded to jail ; after considerable detention her broth- 
er decided to take charge of her, and removed her to his 
house. Recently in a state of high excitement she at- 
tempted the life of her sister-in-law, and but for the 
timely arrival of her brother would have accomplished 
the shocking purpose. Her physician has lately written 
to me, that he regards her as a confirmed maniac, and 
dangerous at all times to be at large, as well as danger- 
ous to all who unguardedly approach her when she is 
excited. 

An insane man has lately been discharged from th6 
jail in Beaufort County, and sent to Hyde, where he be- 
longed. One also from Carteret, as I am told. In Craven 
County, I found a crazy man incarcerated in a noisome, 
damp, cold dungeon ; "placed there for safe keeping!'' 
His condition was very wretched ; and his prospects of 
relief and appropriate treatment no better: if left there 
he must become a confirmed madman* 

In a dark, dreary and filthy dungeon, in Northampton 
County, I lately found an insane man who had been con- 
fined closely for several years. I did not persevere in en- 
tering this dungeon, though I examined others corres- 
ponding with it in dimensions, but cleanly kept. The 
keeper doubted the safety or decency of opening the 
doors , and no advantage could have been derived from 
doing so, merely to attempt the near survey of a place, 
that must assure permanence to disease ; and agravation 
to bodily and mental disability. I am disposed to believe 
that the keeper conceived himself in the performance of 
his duty, to the extent such means as he possessed allow- 
ed. This case I recollect, was repeatedly described, be- 
fore I reached Jackson, by humane and intelligent citi- 
zens in adjacent Counties, better possessed of facts than 
myself, and speaking from personal observation of his 
sufferings, noted in professional calls at the jail, during 
the session of the Courts. 

If Jails are unfit institutions for the treatment and re- 
straint of the Insane, County poor-houses are but a de- 
gree, if indeed at all more suitable. 

/ 



13 

At ihc present tirru 1 , there are no insane persons either 
in the Jail or poor-house of Wake County, but a conside- 
rable number of individuals in private families, in more 
or less suffering and exposed states, according to the abil- 
ity of their friends to provide for them, and several are 
wandering at large, gathering a precarious subsistence, 
and not safe to be trusted .with their liberty. The case 
of several requires prompt care One woman, whose pro- 
pensities are homicidal, resides with her family, to their 
manifest hourly peril. 

The Jail of Orange is well built, and was in good order, 
comparing well with the best kept Jails in the State. 
The reverse exists, in regard to the poor-house, which 
was neither clean nor comfortably furnished. I believe, 
sufficient food is supplied, and in sufficient quantities. 
A little expenditure by the County, and a little care, 
would render the establishment more comfortable. 
There were six insane ; three in close confinement, and 
much excited. The most violent, a man long a maniac 
and caged, was clean, but so noisy as to disturb all on 
the premises ; a large part of the time, the room in which 
his cage was built, could be made light, but was com- 
monly dark and close, " to keep him more quiet!" A ne- 
gro girl, a most pitiable case, was in the opposite build- 
ing ; and a white woman also, in a separate compart- 
ment, vociferous and offensive in the extreme. In the 
passage, between their cells or cages, was a stove in which 
fire was maintained when necessary. The place was 
very offensive. The keeper could not altogether be 
blamed for this ; he was hired to direct a poor-house, and 
not qualified to rule a mad-house, and should not be ex- 
pected to do it. Very many cases of insanity, in various 
conditions, exist in this County. 

Tn Granville County poor-house, is an unfortunate man, 
who for years has been chained to the floor of a wretched 
room ; miserable and neglected, his now deformed and 
palsied limbs attest the severity of his sufferings through 
these cruel restraints ; flesh and bone are crushed out of 
shape by the unyielding irons. He was a man of food 



11 

character, industrious, frugal habits ; a good citizen, and 
respectable as respected ; he became insane, and soon 
the malady assumed a maniacal character: he was car- 
ried to the poor-house, loaded with chains, and left like 
a wild beast to live or perish : no care was bestowed to 
advance his recovery or to secure his comfort ! 

Caswell Jail was in good order, safely constructed, and 
vacant of prisoners. The family of the keeper reside in 
the building. The county poor-house establishment, not 
distant from Yanceyville, consists of a series of decent 
one story buildings, kept remarkably clean and neat, and 
reflecting credit at once upon the county, and those who 
have the immediate charge. Of the four insane residents 
here, two were in close confinement; a woman in a room 
of sufficient size. Who was in a highly excited state. 
The insane man was in a sort of stall or cage, and at the 
season of my visit the place was clean. The noise, per- 
versity, and bad habits of these unfortunate persons was 
a source of much disquiet in the establishment. 

In illustration of the blessing and benefit of Hospital 
care in cases long and most cruelly neglected, I adduce 
the following examples recorded by Dr. Hill, and corres- 
ponding with many cases under my own immediate ob- 
servation since 1840. "Two patients," writes the Dr. 
"were brought to me in 183G, wiio had been confined in 
a poor-housejbetween eighteen and twenty years. During 
this period they had not known liberty. They had been 
chained day and night to their bedsteads, and kept in a 
state so filthy that it was sickening to go near them. — 
They were usually restrained by the strait- waistcoat, and 
with collars round their necks, the collars being fastened 
with chains or straps to the upper part of the bedstead, 
to prevent, it was said, their tearing their clothes. The 
feet were fastened with iron leg-locks and chains. One 
poor creature was so whqlly disabled by this confinement, 
that it was necessary for the attendants to bear her in 
their arms from place to place after she was brought to 
the Hospital; she shortly acquired good habits, and was 
long usefully employed in the sewing- room. The other 



15 

was more difficult of management, but soon gained clean- 
ly habits, and now occupies herself in knitting and sew- 
ing, and that, after having been treated for years like the 
lowest brute. Another case was brought in chains, high- 
ly excited ; five persons attended her; in six days all re- 
straints were removed ; and she walked with her nurse, 
in the patients' gallery. In June, she was discharged 
from the wards quite cured, and engaged as assistant in 
the kitchen. 

The Jail of Rockingham is in tolerably good order, the 
poor-house, but a short distance from Wentworth, is sin- 
gularly neat, and well-ordered ; the inmates sufficiently 
well-clad and very neat and respectable. The build- 
ings require repairs. The house is well kept, but more 
comforts might well be supplied. 

The Jail of Stokes is in tolerably good condition, but 
badly constructed for the admission of light and air 
in the dungeons ; there should be a stove in the passage, 
to dry the walls in damp weather. 

The poor-house about three miles from Germanton, 
is extremely comfortless, the apartments are entirely too 
much crowded, and the arrangements are not suited to 
promote the comfort or good order of the inmates. — 
Rooms of the poor all ill-furnished and out of repair. 
Residence of the Superintendant very neat and comfort- 
able. There was one insane woman then at liberty but 
often confined in a cell, in all respects, unfit for one in 
her condition. I cannot forbear the remark, that when 
not in close confinement, she was very improperly situa- 
ted in the room she occupied. There were several oth- 
ers in the house in a demented state. 

The Jail of Surry, is an isolated old two-story wooden 
building, and in some parts dilapidated ; the poor-house 
is about three miles from Rockford, the Superintendent 
resides in town, and keeps several negroes to look after 
the poor, of whom there were in September, about 30. 
There were no insane in close confinement, but two who 
are allowed the freedom of the place. 



16 

The jail of Guilford, is isolated, hut very ive 11 built 
and well kept : in addition to the dung-eons # and other 
strong rooms, was the unusual provision of a large chap- 
el room lor religious services, when circumstances should 
make it desirable to hold such therein. The old poor- 
house several miles from Greensboro' is about to be 
abandoned, being utterly comfortless and out of repair. 
New buildings on the Hillsboro road are ^nearly com - 
pleted, and there is no doubt that the establishment will 
be in all respects well-ordered, and fitly conducted. 

The jail of Davidson, a new, secure, and substantial 
building was found in excellent order ; the common mis- 
take of insufficient air and light in the dungeons exists here. 
The County poor house about six miles from Lexing- 
ton, was pretty well ordered, but too little visited. The 
supplies of food and clothing seemed sufficient for both 
health and comfort: but there, as elsewhere, the insane 
were out of place, and in a bad state. For this no blame 
is to be attached to the superintendant, so far as I could 
judge. One very crazy man was chained to his bedstead ; 
he was noisy, filthy, and truly repulsive. A crazy wo, 
man, but quiet, was rolled in a quantity of soiled bed 
clothing. These like many others would be useful, and 
decent in their habits, if resident in the hospital expressly 
designed for the insane. Besides these are two demented 
patients. 

Rowan jail, on the first floor of which resides the jail- 
or, is a substanial building — not clean when I saw it ; 
chiefly commended, I was told, as a secure prison. An 
insane man has recently been committed here. The poor 
house about two miles from Salisbury, requires so mueh 
to render it comfortable that it would be difficult to know 
how to enumerate its deficiencies : the house occupied 
by the keeper was quite the most comfortless abode, that 
I have seen in North Carolina, except repaired, certainly 
not habitable for the winter. No insane man in con- 
finement in this institution. 

Iredell jail, is isolated and had just passed into the 
charge of a newly appointed officer, it would hardly be 



IT 

just to remark severely upon its very dirty and neglected 
condition. The County poor-bouse, a few miles from 
Statesville, is situated in a singularly secluded spot, re- 
mote from supervision and often observation, and is a 
model of neatness, comfort, and good order ; having a 
most efficient master and mistress, especially the latter, 
upon whose cares in these institutions by far the most is 
dependent. All in all, this was in much the best condi- 
tion of any poor-house I have seen in North Carolina, 
neat, plain, and decent, it would do credit to any State ; 
but it is no fit place for the insane. Since I was there, 
in September, a highly respected citizen writes me that 
a young woman has been sent to the poor-house so vio« 
lently insane, that it is quite unfit she should remain 
there. Also a man has in that County, very recently 
become so violently mad as to be quite unmanageable, and 
having no Hospital in the State, they have confined him 
with, chains and manacles, hand and feet, and do as best 
they can. A subscription paper has been circulated for 
the purpose of raising funds to send him to Columbia, 
S. C. Other painful cases exist in this, as in the counties 
which I have visited, and from which I have heard; most 
of which I do not feel at liberty, through their domestic 
and social position, to designate ; but they plead ia 
heart-reaching language for the early establishment 
of a State Hospital. 

Wilkes jail is an old building, and so far as the jailor 
is accountable, is well kept : it is isolated, and a wretch- 
ed place whether for the prisoner, or the insane who are 
sometimes confined here. There is no poor-house in this 
County. Five or six cases of insanity have been report- 
ed to me. One, a man named Dowel!, is said by a re= 
spectable physician of Wilkesboro' to have been crazy 
for more than 12 years: the malady is gaining fore* 
gradually, and now exhibiting itself in furious mania; 
he is a very dangerous person to be at large, has proved 
himself to be mischievous, and one© ^attempted to 
commit homicide, 

2 



18 

The Jail of Caldwell is well built, was in good order, 
and has sufficient light and air in every part. There are 
no violently excited insane in the poor house, which is 
some miles from Lenoir, and but few cases in the County. 

In the Jail of Davie, is one insane man ; in the poor- 
house beyond Mocksville, I was informed, was a case of 
insanity truly pitiable, beside many others in the Count}'. 

The Jail of Bertie is an exceedingly well built edifice, 
sufficiently lighted and aired, and well-kept; the Jailor 
and family reside on the first floor ; the County poor- 
house, about three miles from Morgartton, is not well sit- 
uated ; the buildings are out of repair, and ill-arranged 
within, for either comfort or convenience in times of sick- 
ness or of health. I should think that the Superinten- 
dent was kind aud faithful in the discharge of all his du- 
ties towards the poor- Here as in most of the poor houses 
in North Carolina religious services are frequently holden. 

The jail of McDowell, like most of the County prisons 
in thi3part of the State, I found well built and well kept ; 
there is no county poor-house in ov near Marion , and 
my inquiries reached but few insane in the County. One 
man often violently excited, but ordinarily for the last few 
years so tranquil as to be at large, I found beyond Plea- 
sant Gardens. At one time he was closely shut up. 

The jail of Buncombe is a large substantial building : 
formerly there was a county poor-house six or seven miles 
from Asheville, but its remote situation and serious dis- 
comforts through bad management led to the entire break- 
ing up of the establishment some time since. A plan suc- 
ceeded this, somewhat original, which when I was in Ashe- 
ville, had not been fully carried into effect ; having no 
perception of its merits and claims to commendation, I 
shall dwell but slightly upon the subject, merely stating 
on authority of several of the citizens, that it was con- 
sidered in constructing the new jail, expedient to make it 
of sufficient capacity to accommodate at one and the same 
time and place, the vagrants and felons of the county, and 
the unfortunate poor. The enclosed yard, "at present 
unimproved," is of sufficient extent to permit the erection 



19 

of additional buildings "if needful." '-It is belived," said 
my informant, "that the wardens and overseers consult e^ 
conomy by this arrangement in various ways, especially as 
one man can keep the prisoners and the poor, saving the 
cost of hiring a second individual for the latter service." 
"But one pauper has been sent to jail, and he ran away 
dissatisfied with his quarters, in about three weeks." 

Rutherford jail is an old and poor building, but now 
serves sufficiently for the County. 1». is quite isolated; 
but the jailer seemed fitted to fulfil his duties with hu- 
manity and fidelity. The County poor-house, a short 
distance from ilutherfordton, is not so comfortable as 
respects the buildings and furnishing as it should be 
made. The Superintendant seemed a favorite of the 
poor there. 

Cleaveland Jail is excellently built, cleanly kept, and 
the Jailer, as should always be arranged, resides in one 
part of the building, having thereby the more immediate 
and efficient care of the prison. The County poor-house 
about three miles from Shelby, is a small but neatly kept, 
and seemingly comfortable establishment. It seemed to 
me that the Superintendent received an insufficient re- 
compense for the difficult charge the situation of several 
of the inmates involved. 

Lincoln Jail is a well-built, well-planned prison, well 
arranged, and apparently well kept. The poor-house, 
several miles from Lincointon, had but three inmates in 
October ; their condition was uniformly represented as 
not good, and the establishment described as being ob- 
jectionable. Perceiving influential citizens, prompt to 
admit existing evils, I did not personally visit it. No in- 
sane at present are confined there. Several in distressed 
conditions in the County, in private families. 

Gaston Jail is as yet unfinished, but appears to be a 
well-planned building. No poor-house in or near Dal- 
las ; but one such needed for the County poor» Several 
insane in the County. 

Mecklenburg Jail is remarkably well planned and well 
built, but less well kept than are most County prisons in 



20 

Kortb, Carolina; as respects clean tineas. The County 
poor-house, several miles from Charlotte, was nearly de- 
serted in October, having but two of the County poor ; a 
partially insane woman, and a paralytic man. 

Cabarrus Jail is a large, well constructed building — id 
tolerable order ; the Jailor occupies commodious apart- 
ments upon the first story.; The County poor-house about 
two and a half miles from Concord, is very deficient in 
means for promoting the comfort of the infirm inmates. 
In a miserably dilapidated out-building, perhaps ten feet 
square, open on all sides to the ingress of the winds, rain, 
and snow, I found a crazy man chained to the floor, filthy 
and disgusting. At times he is suffered to go at large, 
but is at once troublesome and dangerous to those he 
meets, or whose house he frequents. In a Hospital, this 
crazy man would, under judicious care, be able to per- 
form more labor than would suffice for his own mainten- 
ance. I did not visit the insane scattered in private fam- 
ilies. 

Stanly Jail is a small new building, neat and secure, 
but the dungeons so planned and constructed as almost 
to assure the destruction of health to any who might be 
long in detention ; there is hardly a possibility for the 
admission of sufficient air to support the absolute demands 
of the animal structure. There are in the County seve- 
ral cases of insanity requiring Hospital treatment. At 
present, there is no poor-house in on near Albemarle. 

Montgomery Jail, like that of Stanly, is a neat sub- 
stantial building, and well-kept, but not well planned 
for health, as respects the admission of light and air, 
though it assures security. 

The County poor-house, at Lawrenceville requires, it 
appeared to me, much more careful attention on the part 
of the Wardens, to supply comfortable and necessary at- 
tendance upon the aged and infirm, who alone occupy 
the buildings. Nothing could be more creditable to t hese 
feeble women than the neatness and care with which 
they kept their apparel and their apartments. An in 
$?me man bad been removed to some other situation in tha 



County. Several cases of insanity were related to mo 
on authority. 

Moore jail seemed a secure prison; its want of cleanli- 
ness was excused on the ground of there being no pris- 
oners, and being occupied as a lodging for servants. 
The dungeons, which did not serve this use, were by 
comparison with the majority of prisons in the State, in 
bad order. The County poor-house, not distant from 
Carthage was excellently kept by a conscientious and 
kind-hearted family, to whose cares the comforts of the 
inmates are aseribable, rather than to the provision made 
by county officials. The buildings are much out of re- 
pair and unfit for winter habitation, or for stormy days 
at any season. The custom so worthy of entire condem- 
nation, that of setting off the poor in mass, by lots or sin- 
gly, to the lowest bidder exists in Moore County. The 
poor are fed, clothed, supplied with bed, clothing and fuel 
and waited on at the rate of 8 cents the day each ; a sum 
which cannot pay those who undertake this charge. 
That I found the poor well supplied with food and well 
clad, I repeat was certainly aseribable to the liberality 
and Christianity of the present keepers, rather than to 
the just guardianship of the public. 

Cumberland jail is an old building, well lighted and 
well ventilated: it is said that more attention will be 
paid to the preservation of cleanliness than heretofore, 
the keeper and famlj" now residing upon the premises. 
The county poor house within three miles of Fayetteville 
is well situated, and apparantly excellently kept : clean- 
liness, that crowning excellence in house-keeping, prevail- 
ed in every room save one, and I imagine might with the 
exercise of a sufficient determination, be secured even in 
that. In a log building well constructed, and admitting 
sufficient light and air, planned so as to be warmed in 
damp and cold weather : were two small apartments for 
the insane : at the time I was there one room was vacant, 
the other was occupied by a violently excited and noisv 
insane man, whose shouts and vociferations reached ma 
at a distance from the p-oor-house. In a hospital this 



<¥} 



poor creature's energies would tind exercise in useful em- 
ployment ; in a poor-house it is not to be expected that 
the superintcndants should have the qualifications which 
pertain to a judicious control of maniacs: moreover 
the noise and disturbance these create, banish comfort 
and repose from the infirm, the sick, the dying , and the 
demoralizing influence, through use of profane language 
and additional evils. In this poor-house religious services 
are regularly and frequently holden, and one has evi- 
dence that the ministers of the various religious denomi- 
nations in the vicinity had not overlooked that scripture, 
" To the poor the Gospel is preached which foretold the 
advent of Jesus the Saviour, and comforter." 

The jail of Sampson is said to be decently kept. The 
county poor are said to be well clothed and supplied with 
wholesome food. Several cases of insanity have been 
related in this county 

The jail of Duplin is defective. The wardens of the 
county poor-house which is situated east of Warsaw, sev- 
eral miles from Kenansville, have the reputation of giv- 
ing uncommon attention to the temporal and spiritual 
comforts and consolations of the poor. Religious ser- 
vices are holden at the poor house. At present there are 
no insane persons there. 

The jail of New Hanover appeared to be tolerably 
■well kept. It is a large commodious building. Too lit- 
tle light and air are admitted into the dungeons. The 
county poor-house on the confines of Wilmington is in a 
miserable and dilapidated condition ; fallen wholly from 
its former well deserved reputation of being one of 
the best Institutions for the poor ia the country. Ap- 
parently the acting wardens are responsible for its de- 
cline. There are affecting and suffering cases of insani- 
ty in several private families in this County. 

Wayne jail is an old dilapidated building,-shortly to be 
replaced by a new prison. Found in miserable condi- 
tion. The County poor-house several miles from Golds- 
boro'. seemed quite decently kept, and in many respects 
bore an air of comfort. There seemed to be neglect from 



abroad in the attendance upon the sick ; several individ- 
uals were evidently suffering from want of medical ad- 
vice and prescription. This establishment is but seldom 
visited, and the comforts enjoyed seemed chiefly referable 
to the caro of occupants. One of the poor, an insane 
man, had wandered away : an insane woman was so far 
controllable as to be steadily and usefully occupied. 

Lenoir jail, a very old and isolated building, but strong^ 
seemed pretty decently kept ; it has some very great de- 
fects of construction. The poor of the county are not 
numerous, by comparison with the adjacent Country. 

Craven jail, a very large brick building, promising ex- 
teriorly a better condition than the interior revealed. 
The dungeons were very bad, offensive, dirty, ill-lighted, 
and not ventilated. A very insane man, considered dan- 
gerous to be at large, was in one of them ; he was cold, 
exposed, and suffering ; his condition was such as to as- 
sure agravation, if not permanent confirmation of his 
malady. There are no means of maintaining either 
dryness or warmth in the passages or in the dungeons. 
The county poor-house, a short distance from Newbern, 
is well situated, and has the reputation of being well 
kept in general. The keeper's house, and several rooms 
occupied by the poor, were neat and well-ordered; others 
were in a poor condition. A Sunday school is taught 
here by persons from Newbern, whose Christianity is il- 
lustrated in their practice of its precepts. There are here 
in Craven Count}', many cases of insanity. 

Beaufort jail is a neat brick structure ; the jailor oc- 
cupies the lower floor in front. The plan of the prison is 
not good, though it assures security when properly at- 
tended to. 

A letter received from a physician resident in Wash- 
ington, informs me that since I left that town a week 
since, an insane man in a state of high excitement, has 
been committed to the jail there for public security, and 
occupies a dreary, wretched cell. I cannot question the 
willingness of the jailor to perform his duty as humanely 
as possible ; but there is no mercy nor humanity in com- 
mitting the insane to prisons. 



34 

The unfortunate man above alluded to might, in a wejl 
ordered Hospital, undoubtedly in a short time be sufficient- 
ly recovered, if not cured, to pursue some useful and pro- 
fitable employment. 

Recently fifteen cases of insanity have been stated, ex- 
isting in this section of the State — that is in Beaufort, 
and adjacent Counties. 

An insane person with whom I was conversing two 
weeks since, dwelt with profound feeling upon the trials 
and sufferings she endured, conscious of her state, and 
sensible of ail that occurred around her : that which most 
moved my feelings at the time was, the indescribable pa- 
thos with which she related the sufferings and hardships 
of a crazy man confined in the Jail in her native County. 
She concluded, " I, in my troubles, have friends — he has 
none." 

The county poor-house not distant from Washington, 
and reached over a good road, is pleasantly situated, but 
in a spot well known for its unhealthiness, having been 
abandoned by the former owner of the property, for its 
liability to create fevers, and for the general insalubrity 
of the place. The establishment needs an efficient Su- 
perintendant, competant in mind and body to carry for- 
ward the interests of the place. Offering at first glance 
the appearance of a comfortable institution, it fails to 
show forth either private or public efficient and fit direc- 
tion. The sick and the children certainly suffer ; and 
those able to work need a director to insist upon their 
action. I found one woman here insane, but quiet. 

Pitt jail is a neat, two story building painted white, 
and sufficiently large for present county purposes. The 
poor of this county are said to be well cared for. Sad 
and distressing cases of insanity were brought to my no- 
tice existing in private families, in conditions of extreme 
suffering and exposure, of which I do not feel at liberty 
to give the history. 

Edgecombe jail is a well constructed, isolated prison ; 
well and cleanly kept : its defects of plan and arrange* 
ment are fewer than ordinary in county prisons. I did not 



25 

visit the poor-house of this county established some dis- 
tance from Tarboro, but it bears a good reputation, and 
at present there are no violently excited insane there -, 
cases are known abroad in the county. 

Halifax Jail is a well built prison seemingly, though 
isolated, securely kept, but bears the reputation of being 
deficient in cleanliness. At present no insane detained 
there. The poor-house nearly three miles from Halifax, 
has much need of competent care, and efficient superin- 
tendence. Most of the inmates are aged and infirm. 
The buildings are well situated and conveniently plan- 
ned for the oocu pants, but deficiently furnished, except 
one room furnished by the individual who dwells in it. 
The sick need nursing, care, and comforts ; and all re- 
quire supervision. 

Northampton Jail is well-built, but defectively plan- 
ned — the dungeons, of which there are four, are insuffi- 
ciently lighted and ventilated, and however cold or damp 
are never warmed and dried. Here is an insane man con- 
fined for years in this dreary abode ; from his sight, the 
genial sun, the beautiful sky, and the green fields are 
forever shut out ; darkness, and foul air, and solitude, 
heaviness and misery are his portion. Kindred and 
friends are put far from him, and his acquaintance into 
darkness. May the merciful God compassionate those 
who are so cruelly abandoned by their fellow-men, and 
may no heavy retributions crush those, who so unhesita- 
tingly and unpityingly consign a helpless, crazed crea- 
ture, to such a hapless doom. 

The poor-house, a mile and a half from Jackson, con- 
sists of five dilapidated, unfurnished rooms, at pre- 
sent abandoned. The Superintendant who resides in 
a pleasantly situated comfortable house, distributes 
quarterly, to one hundred beneficiaries an allowance of 
meat, meal, and clothing, at a cost to the county of about 
$2,500 00. Several insane poor, B and others in better 
circumstances are in this County. 

The jail of Nash is a small two story decent building; 
no insane now confined therein. The poor=house I had 
4 



26 

sot time tc visit, but understand it is comfortable. Sever- 
al cases of insanity were reported to me existing in the 
county. 

Time would fail in the narration, even were it proper 
to unveil the miseries, protracted, and indiscribably va- 
ried, of the insane in private families, and the distress of 
families thrown into sorrow and trouble unequalled, 
through the affliction and sore perplexities arising out of 
care over the demented, the epileptic, and the maniac. 
A detailed description of their personal condition, horri- 
ble as it must be, could not present the half of the woes 
which exist in every county throughout North Carolina, 
Loathing and horror would overwhelm the reader, sue • 
cessively introduced to dreary apartments, loathsome cells, 
and foul cabins, whence issue the most horrible sounds 
and poisonous effluvia, and wherein are spectacles of 
protracted bodily and mental misery language is poor 
to represent. 

Of the few examples of many which exist, to which I 
shall now refer in private families, the following have 
quite recently come under my observation : A poor but 
industrious farmer in the western part of this State, the 
father of a numerous family, became insane; it was in 
vain to control him in his own dwelling, he was furious 
and he was conveyed to the County jail ; here his suffer* 
ings were aggravated and his malady exasperated; I can* 
not tell for how long a time the lone dark dungeon echo- 
ed to his moans and cries, nor at what cost the county 
maintained human life, unaiding its sufferings and neces- 
sities. In process of time the paroxysms of violence sub- 
sided, and finally he was transferred to the humble log 
cabin of his aged widowed mother, alone woman dwell- 
ing upon the mountains. There I found the infirm, af- 
flicted mother, and the insane son. Amidst tears and 
sighs she recounted to me her troubles, and as she wept 
she said, M the Lord above only knows my troubles, and 
what a heap of sorrow I have had in my day, and none 
tofgive me help. There he lay in the jail, cold and dis- 
tressed, nnd mightily misused ; if I could have got mo- 



27 

ney to send him off to where they cure such spells, for 
they do say crazy folks can be cured, I should have had 
him in my old age to take care of me, but I am poor and 
always was, and there is no help here. Ah well, many 
and many is the long night I am up with him and no 
sleep or rest, anyhow; this cant last always; I shall die, 
and I dont know what is to come of him then." It is 
for Legislators to determine whether such as these shall 
drag out troubled existences, and no succour until the 
Angel of death brings release, and seals the long record 
of "man's inhumanity to man." A respectable citizen in 
the same quarter of the county, by very slow degrees lost 
his reason. First was a nervous restlessness, next un« 
wonted irritability, then a craving for stimulants, which 
were in time used to excess, and quickened the malady, 
yet none then traced the real cause of the growing evil : 
but the type of a deranged intellect was shortly devel- 
oped beyond doubt, and in a few months the distress and 
trouble, of the household knew no alleviation nor interval. 
Finalty, removal from home, under most grievous cir- 
cumstances, ensued, and I have not long since been wit- 
ness to the afflictions of this worthy and respectable fam- 
ily whose efforts to sustain themselves are as affecting 
as praiseworthy. Had there been in North Carolina, a 
State Hospital, timely care might have secured a perma- 
nent cure. It is almost too late to assure this now, but in- 
stead of restoration is life-long expense, and life-long 
suffering. 

In Lincoln County, near a public road, stands a decent 
dwelling ; near by is a log cabin, strongly built, and 
about ten feet square, and about seven or eight feet high ; 
no windows to admit light ; the square logs are compact- 
ly laid ; no chimney indicates that a fire can be kindled 
within, and the small low door is securely locked and 
barred. Two apertures at right angles, ten inches long 
by four wide, are the sole avenues by which light and 
air are admitted within this dreary cabin, so closely se- 
cured, and so cautiously guarded. You need not ask to 
what uses it is appropriated ; the shrill cri6S, and tern- 



28 

pestuous vociferations; of an incarcerated maniac Will 
arrest you on the way, and if you alight, and so far as 
the light received as before described will allow, exam- 
ine the interior of this prison, you will discern a fero- 
cious, filthy, unshorn, half-clad creature, wallowing in 
foul, noisome straw, and craving for liberty. The horrors 
of this place may not be more definitely descibed ; they 
can hardly be imagined : the state of the maniac is re- 
volting in the extreme. This creature, is a man — insane 
for more than thirteen years — for a longtime suffered to 
range the country far and wide, addicted to mischief and 
disposed to violent acts. For assuring public and pri- 
vate safety, his family have adopted the only alternative 
of confining him upon their own farm, rather than see- 
ing him thrown into the dungeon of the County jail. Of 
these two evil conditions, I confess, I see no choice. The 
family though enjoying the means of decent livelihood, 
when unburthened by extra expenses, have not the means 
of sending him to a distant Hospital. The rich may 
partake the benefits such institutions afford : the poor 
must suffer, agonize, and bear heavily out, by slow-kill- 
ing tortures, their unblessed life ! Are there no pitying 
hearts, and open hands that can be moved by these mis- 
eries ? 

Well and truly may it be said of the insane : whose 
sorrows are like unto their sorrows, and whose griefs are 
like unto their griefs? Friend and companion are re- 
moved far from them, and their acquaintances are hid 
from their view ! 

Of thirteen cases of insanity in and near Raleigh, there 
is one to which my attention has within a few days been 
called, which especially illustrates the want of a Hospital 

for individuals in narrow circumstances. Mrs. ~— 

has for several years had rather feeble health. Some- 
time in February last, she manifested peculiar restless- 
ness by day and night, became agitated and nervous, and 
her mind was subject to strange and harrassing delusions 
From that time she became incapable of attending to'the 
affairs of her household ; neglected her child, and passsd 



29 

most of the time night and day in traversing the small 
apartments of her dwelling. Her husband, dependent 
upon daily industrious labor for a decent support, found 
himself embarrassed by the distresses of his home and the 
claims of business. He is unable to pay her expenses at 
any Hospital ; meanwhile, she is sinking into a conditiou 
of hopeless and permanent insanity. She who was neat, 
modest, industrious, and kind, is now through this most 
afflictive malady, utterly transformed ; her garments are 
rent in tatters, her person neglected, her hair dishevelled, 
falls in tangled locks about her head ; her speech is no 
longer gentle, true and kind; but violent, profane, and inde- 
cent ; in that humble, once pleasanthome, is now neither 
peace, nor rest, nor security : there is constant danger of 
destruction by fire, and acts of personal violence often 
recurring, indicate the increasing liability to deeds in- 
volving fatal consequences : in train with these alarming 
manifestations, are symtoms of a suicidal disposition. It 
has been found necessary at times to confine her move- 
ments by the application of painful modes of restraint 
upon the limbs ; which, though preventing present mis- 
chief, continually aggravate the malady. Hospital treat- 
ment might restore this patient to her family blessings, to 
society, and to usefulness. 

Many cases of maniacal insanity have been removed to 
Southern and Northern Hospitals. Hitherto, North 
Carolina has been willing to be dependent upon other 
States for her afflicted children, while in possession of 
ample means to succor and heal their maladies within 
her own-borders. But there are other objections to trans- 
porting patients to distant Hospitals for remedial care, 
beside the fact of encroachment upon the Institutions of 
other States. Expenses are vastly increased in making 
long and always difficult journeys under circumstances so 
harrassing and painful ; and an experienced physician of 
a celebrated Hospital has informed me that the fatigues, 
excitement, and exposures of several patients, conveyed 
long distances, have within the present year resulted in 
death. "Want of sleep and exhaustion, have reduced them 



30 

to the most dangerous condition before being received ; 
and not seldom depleting remedies injuriously adopted, 
have hastened dissolution. If there is cruelty and gross 
injustice in holding the insane in jails, poor-houses, and 
private families, there is serious risK: of property and of 
life in leaving them to range at large. Plainly, there is 
but one remedy. 

In Aberdeen, Ohio, an insane man, left in the room 
where a little girl three years old was sleeping, in the 
absence of the mother, threw down the Bible which he 
was reading, seized an axe. and deliberately chopped the 
little victim into five pieces. 

In Rowan County, N. C, a maniac cut her husband's 
throat. In Wilkes bounty another beat her husband up- 
on the head so as to cause his death. In Rockingham 
an insane man killed his neighbor. A man in Kentueky 
killed two of his children, and attempted the life of his 
wife. Another in Indiana cut his wife's throat and gashed 
her face so that she died. Besides these, I recollect more 
than thirty similar cases in which homicide was attempt- 
ed and committed by individuals known to be insane. 

1 adduce a few, from many thousand examples on re- 
cord, which illustrate the benefits of Hospital residence 
and of remedial treatment of the Insane, in both curable 
and incurable cases. 

"There has been," writes Dr. Bates of the Maine State 
Hospital, "in this Institution for some years, an individ- 
ual whose family is strongly disposed to maniacal insan- 
ity. By many years neglect this patient became incura- 
ble ; the powers of the brain seem to exist in fragments. 
He is, and probably always will be a public charge. Two 
of his sons have been attacked, seasonably brought under 
treatment, and cured. These young men during the ab- 
sence of disease, were industrious and frugal citizens. 
They are both liable to a recurrence of the hereditary 
malady. If brought to the Hospital soon after each at- 
tack, there are nine chances in ten, that they will always 
soon recover and return to their occupations and former 
place in society ; if neglected until functional derange- 



31 

ment changes to organic disease, they will become a pub- 
lic charge for life," These cases are selected plainly to 
illustrate the fact that economy not less than humanity 
calls for early and efficient action in assuring appropriate 
remedial treatment for the insane. 

Dr. Stribling, the excellent physician and friend of the 
insane, and Superintendant of the Western State Hospi- 
tal in Virginia, states several cases of much interest in 
his published reports to the Legislature. From these 
documents I quote the following examples : In 1842, a 
young gentleman, twenty-one years ot age, the son of a 
highly respectable individual who was formerly a prom- 
inent and efficient member of the Legislature of Virgin- 
ia, was brought to our Hospital. Possessed of a good 
natural understanding, improved by education and such 
other advantages as wealth had supplied, and with a dis- 
position uniformly cheerful, he was at all times a most 
interesting patient and companion. In the Autumn of 
1842, he was attacked with bilious intermittent fever, 
which although speedily arrested, was followed by de- 
pression and neglect of fill accustomed duties and care of 
property. In about two months the mind became haras- 
sed by the most distressing delusions, such as being sur- 
rounded by foes who were plotting his destruction ; his 
friends were regarded as enemies, and he believed himself 
doomed to eternal punishment, &c. He remained in this 
state for some time, when suddenly he passed into the 
highest degree of cheerfulness and gaiety. Affection for 
his family revived ; he fancied himself by turns poet, 
philosopher, and statesman; at one time he was an angel 
in Eden, at another Noah defying the destroying flood, 
and finally he conceived himself the Creator of the Uni- 
verse. He was removed to the Hospital where the ap- 
plication of moral and medical means in a short period 
assured his recovery : he left us rejoicing in the blessing 
of restored health. 

A respectable gentleman who had been esteemed bv 
all who knew him, as an affectionate husband and father. 
a generous friend and worthy citizen, was received as a 



32 

patient in the Western Hospital, in 1843. He was a 
merchant, and through unavoidable misfortunes rather 
than ill management, sustained heavy losses: he became 
depressed, was attacked with bilious fever, which left his 
health materially impaired ; after some months his friends 
became satisfied that his mind was seriously diseased ; evi- 
dences of insanity were multiplied ; he became maniacal 
and his family under the advice of an intelligent physician, 
placed him in the Hospital. He was feeble, emaciated, 
sleepless, and suicidal. His delusions varied, and were 
of a most distressing character. Demons seemed to sur- 
round him and to multiply their torments. In a short 
time his malady seemed to yield to remedial measures. 
His physical health improved ; his mind gradually be- 
came tranquil ; one delusion after another disappeared ; 
his spirits revived, and soon he was pronounced cured, 
and returned to his family, and to his business, a cheerful 
and happy man." As he was from that class of society 
which possesses extensive influence, and who in this part 
of the country, unfortunately, are too apt to regard insti- 
tutions for the insane with aversion, and who consent to 
place their afflicted friends therein only when all other 
means have failed, and all other sources of hope cut off, 
it may not be amiss to quote a passage from one of his 
letters received by a friend after his recovery and by him 
communicated to his physician. 

'•I am truly happy to inform you that my health is now 
perfectly restored. I cannot say too much in praise of 
this institution, nor too earnestly express my gratitude to 
my friends for having placed me here. Instead of a 
place approximating to a prison, as I once considered it, 
when influenced as many are by ignorance and preju- 
dice, I now view the establishment in the light of a 
pleasant hotel. 1 gratefully acknowledge comforts sup- 
plied and kindness received." 

•'Last year the wife of a respectable and independant 
farmer was brought to the Hospital in a most painful 
condition. She was endued by nature with a clear and 
vigorous intellect, being emphatically, a strong-minded 



33 

woman," remarkable for her industry, discretion, and 
good management. She had not encountered those diffi- 
culties and disturbing cares that often wear out^the 
heart, but had led a life of peace and enjoyment. Some 
time in the year before insanity was manifested, her 
strength seemed to diminish without apparent cause. 
Finally her mind became a prey to the most harassing 
delusions; she fancied herself given over to everlasting 
condemnation : believed herself the destroyer of a friend ; 
attempted suicide, and after six months lost in unavail- 
ing attempts to restore her, she was placed in the Hospi- 
tal at Staunton. There was a continual conflict between 
her feelings and her reason, her affective and her 
intellectual faculties, which rendered her case one of 
care and interest. In a few months she was perfectly 
restored. 

In 1848, a young lady of cultivated mind and accom- 
plished manners sunk into a state of agitated depression. 
Change of scene, cheerful society, exercise and medical 
skill were employed in vain. Her affections towards her 
friends passed into indifference, and so to settled aver- 
sion. To her distempered fancy her husband, parents, 
and sisters appeared transformed to demons. The dis- 
tressed mother could not see her child transferred to a 
Hospital, and long resisted the entreaties of wise-judging 
friends. The disease became for seven months continu- 
ally more aggravated, till finally amidst lamentations 
and anguish her family consented to her removal. Her 
improvement was rapid, and restoration finally complete, 
and instead of distress at the thought of finding herself 
the inmate of a Hospital for the insane, she often exclaim- 
ed, " Oh why did not my friends place me sooner here." 
To a relative she wrote, " this is no prison, but a refuge 
for the distressed, where every comfort is furnished, and 
only the most soothing attentions experienced. I will 
ever cherish the most grateful recollection of this Hos- 
pital and of the excellent physician through whose skill 
by Heaven's blessing I am recovered "' 



34 

" A rnaaborn of respectable and pious parents instruct- 
ed from his youth in lessons of morality and religion, 
grew up a peaceable, industrious, and u seful citizen. 
His disposition was mild and gentle, his feelings affec- 
tionate, and his habits exemplary. The decease of his 
mother overwhelmed him with affliction : he fell into a 
state of what is termed religious melancholy, and grad- 
ually became agitated and furious ; suddenly attempted 
the life of his wife and children, killed one of the latter, 
and seriously wounded the others. He destroyed at a 
blow a neighbor, who attempted with others to secure 
him, and was at last with difficulty secured, and lodged 
in the jail, and shortly brought to the Hospital. Months 
passed and he continued excited and dangerous. Very 
gradually a change took place ; his habits improved ; his 
physical health improved, and from being one of the most 
loathsome and offensive patients ever introduced into 
the institution, he became decent, quiet, cleanly, and 
finally rational, peaceable, and in all respects well 
behaved. He remained in the Hospital five months af- 
ter the recovery of his reason, to ensure the safely of his 
return to society, and was finally, through the solicita- 
tion of his family and friends, upon their special appli- 
cation, discharged by the Court of Directors. Thus far 
his recovery seems to be permanent." The danger of 
delay in placing the insane under remedial Hospital 
treatment cannot be too strongly insisted upon. Hun- 
dreds and thousands of cases attest the cruelty and the 
folly of procrastination. However writers upon insan- 
ity, and medical men may differ upon some points, on 
this question all agree, and deprecate with forcible argu- 
ments the dangers of piocrastination. Esquitol, Pinel, 
Falret, Jacobi, Conolly, Bell, Brigham, Awl, Kirkbride, 
Stribling, and a host of others, have earnestly and re- 
peatedly enforced, and continue to enforce this truth ; 
and employ the most eloquent persuasions to induce 
friends and guardians to take advantage of Hospital treat- 
ment in the early stages of the malady. Willis, the cel- 
ebrated physician to George the III, dismissed the king's 



35 

family, courtiers, officers, and domestics ; procured stran- 
gers as nurses and attendants, and thus first succeeded 
in controlling the delusions which distracted the insane 
monach. " To separate the insane from the objects sur- 
rounding them at the origin of the disease, writes M. 
Pinal, to entirely disconnect them from their habitual 
intercourse with their relatives, friends, and servants, is 
the imperative and indispensable plan for commencing a 
course of treatment which shall be attended with favor- 
able results:" and Falret, says, "it is demonstrated by 
repeated experience, that the kind of isolation preferable 
to all others, is that of an establishment especially devo* 
ted to the insane." "Few," writes Hallaran, "very 
few patients are fouud to recover under domestic treat- 
ment." There can be but one opinion as to the solemn 
duty of the removal and non-intercourse of the insane, 
with their intimate friends and family j and their familiar 
homes. The superintendant of an English Hospital 
writes in 1842, as follows: "In a large proportion of 
cases admitted the present year, owing to long detention 
by friends, or by parish officers, the prospects of recov- 
ery have been entirely precluded, and in successful cases, 
the period of treatment bears generally an accurate ratio 
to the prior duration of the disorder." The visiting com- 
missioners of the sane Hospital report, that "they cannot 
too strongly express their conviction, from experience, 
that the hope of cure is materially lessened, and not unfre* 
quently defeated, by the delay which is suffered to take 
place in sending patients to the Hospital after first con- 
firmation of their malady." The physician of the York 
Retreat, states in an annual report, that "forty-nine years 
of experience establishes the fact of recovery of four 
cases to one brought under cure within three months of 
the first attack, while it is less than one to four in cases 
of more than twelve months duration when admitted." 
The superintendant of the Edinburgh Hospital shows 
that " to be treated successfully, insanity must be treated 
early ; ill founded prejudices, and false sensibility often 
operate to prevent this being done." These remarks ars 



as general and as often reiterated as are the establish- 
ment of Hospitals and the issue of reports emanating 
therefrom. Dr. Earle, shows from his experience in the 
treatment of the insane, that, " after the three first 
months of insanity are passed the probabilities of entire 
restoration rapidly diminish." Not only do delays in 
placing patients in suitable Hospitals involve the risk of 
permanently establishing the malady, but the safety of 
property and security of life is hazarded in a vast many 
instances. 

Dr. Gait records an example in point, as occurring in 
Virginia. An insane woman, the mother of a family, be- 
came so much the victim of distressing delusions, that her 
family perceiving danger from her being at large, took 
her before the justices for examination in view of placing 
her in the Hospital at Williamsburg. The following 
letter was addressed by one of these to the President and 
Directors of that institution. "Sirs — at the time an ex- 
amination was had into the state of Mrs. mind, she 

seemed so lucid that one of the magistrates, who had not 
seen her previously, dissented from the opinion of the 
other two, imagining that the public were in no danger 
from her going at large; and had the examination taken 
place one hour later, no doubt would have been felt upon 
the subject by that gentleman, as she became so furious 
shortly after, as to render it necessary to confine her in the 
public jail. After a few days she became importunate to 
return to her husband and children : and a call of her hus- 
band at the jail increased her supplications to be set 
free. He finally prevailed with the jailor to take her 
home, promising to return the next day to give bond and 
security for her restraint and safe-keeping. In the night 
she rose unperceived, proceeded to the yard and pro- 
cured an axe. and after calling the servant who slept in 
the room, and finding him asleep, gave her husband ma- 
ny blows over the head, fractured his skull in seve- 
ral places, and left him senseless. She left the house 
and ran unremittingly for several hours ; affirmed her- 
self dead, and declares that she has been buried these 



37 

five years. 1 have made these remarks to illustrate her 
case and assist treatment of the same." Another case 
occurring in Eastern Virginia, seems worthy of notice ; 
there are but too many parallel cases in North Carolina. 
The friends of the young woman referred to were in lim- 
ited circumstances, and even by making considerable 
sacrifices could not succeed in rendering her comfortable 
at home: they entertained the strongest prejudices 
against Hospitals for the insane. .She was violently ma- 
niacal, breaking in pieces and tearing every thing upon 
which she could lay her hands ; and vociferated perpet- 
ually in the most harsh and discordant tones. She was 
almost constantly confined in a small closet or cell con. 
structed in a small apartment in her mother's house : oc- 
casionally, for change, she was taken into the open air 
and confined to a tree by heavy chains. At the time she 
was removed to the Hospital, she had contracted the 
most loathsome habits, and had plucked the whole of the 
hair from her head. For more than two years she had ex - 
hibited a most pitiable spectacle, and every day her misery 
seemed to be increased. After several months residence 
in the Hospital, her improvement commenced : her recove- 
ry is slow, but it is hoped will ultimately be complete. 

In a report from Dr. Stribling, the following statement 
is on record : "Of all the cases received, ninety-seven 
were recent cases, of whom eighty-three were restored to 
reason ; jive remain in an improved condition ; three are 
unimproved ; and six died before any opportunity was 
offered to test the use of remedies in their behalf. These 
results correspond with those of other institutions. Of 
one hundred and fifty -eight, cases remaining in the Hospi- 
tal at Staunton in 1845, and in all probability doomed 
for life to endure the weary burthen of remediless dis- 
ease, how many might have been restored to reason, hap- 
piness and usefulness, had they been subject to early 
and appropriate moral and physical treatment. In ma- 
ny cases the morbid sentiment of friends led them to re- 
ject Hospital aid 9 and now the care and skill are all too 
late ! 



38 



The following Table, writes Dr. Allen of the Kentucky 
Hospital, shew the Cases of less than One Years Duration 
admitted into the Asylum, from July 1st, 1830, to Septem- 
ber 30th, 1847; the Number of those cured, Relieved, Un- 
improved and Died, and the Per Cent- of Cures to Admis- 
sions and Discha?'ges. 



ADMITTED. 


Recov- 
ered. 

94 
51 


Reliev- 
ed. 


Unim- 
proved. 

8~ 
2 


Died. 

9 

7 


Per ct. of 
Cures to 
Admissions. 

74.15 
69.86 


Per ct. of 

Cures to 
Discharges. 


Males, 127 

Females, 73 

200 


16 
13 


91.23 
87.93 


145 


29 


10 


16 


72 05 


90.62 



"I have intimated," says the same judicious physician, 
"that such public institutions for the insane, as afforded 
every facility lor their successful treatment, and such as 
to invite the early committal of them to Asylum discipline, 
were demanded on the score of economy. I would not, 
in the mean time, have it forgotten, that the illustration 
of this position, applies to persons who maintain their 
insane friends at private charge, as well as to the State. " 



39 



The following Table shows the truth of the intima= 
tion, and the reason why it is so : 

A Tabic showing the comparative cost to the State of twenty old and twen- 
ty recent cases of insanity, illustrating the importance, in an economical 
point of view, of placing such persons under treatment at an early period 
of their disease, and of providing every means of treating the?n success- 
fully in an Asylum. 



OLD CASES. | 




RECENT CASES. 






Cost of 
















each case 








Cost of each 


-Vo. 


Age. 


Time'spent 


at 65 dol- 


No. 


Duration before. 


Time spent in 1 


oase at 1 dol- 






In Asylum. 


lars per 


admission. 


Asylum. 


lar and fifty 








annum. 








cents per week 


"1 


47 [20 years, 


#1,300 


~ ] 


1 week, 


36 weeks, 


£54 00 


2 


48 


20 years, 


1,300 


2 


! 7 weeks, 


1 6 weeks, 


24 00 


3 


52 


17 years, 


1,105 


3 


3 months, 


32 weeks, 


4S 00 


4 


54 


16 years, 


1,140 


4 


9 months, 


40 weeks, 


60 00 


5 


47 


17 yenrs, 


1,005 


5 


2 months, 


20 weeks, 


30 00 


6 


46; 15 years, 


975 


6 


2 months, 


20 weeks, 


30 00 


7 


51 1 14 years, 


910 


7 


3 months, 


12 weeks, 


18 00 


8 


31 


13 years, 


845 


8 


1 month, 


20 weeks, 


30 00 


9 


33 


11 years, 


715 


9 


2 months, 


28 weeks, 


42 00 


10 


45 


12 years, 


780 


10 


3 months, 


24 weeks, 


36 00 


11 


37 


10 years, 


650 


11 


6 months, 


24 weeks, 


36 00 


12 


39 


10 years, 


650 


12 


6 months, 


32 weeks, 


48 00 


13 


33 


12 years, 


7S0 


13 


4 months, 


2S weeks, 


42 00 


14 


45 


15 years, 


975 


14 


4 months, 


12 weeks, 


18 00 


15 


48 


16 years, 


1,040 


15 


6 months, 


8 weeks, 


12 00 


16 


56' 12 years, 


780 


16 


1 month, 


8 weeks, 


12 00 


17 


44 13 years, 


715 


17 


2 months, 


24 weeks, 


36 00 


18 


47 15 years, 


975 


18 


1 month, 


20 weeks, 


30 00 


19 


36 13 years, 


845 


19 


6 months, 


12 weeks, 


18 00 


20 


36 9 years, 


580 


20 


1 month, 


20 weeks, 


30 00 




""1 


.$18,030 








t $654 00 



Aggregate cost of 20 old ca- 
ses, #18,030 00. 

Average time spent in Asy- 
lum by>ach, 14 years, 

Average cost of each case, 
S901 50. 



Aggregate cost of 20 recent cases, ,^654 00, 
Average time spent in Asylum, nearly fiva 

mouths. 
Average cost of each case, $32 14. 



Moral treatment of the insane with a view to induce 
habits of self-control, is of the first importance. Uni- 
form firmness and kindness towards the patient are of 
absolute obligation. The most exact observance of truth 
should be preserved in all intercourse with the insane. 
They rarely violate a promise, and are singularly sensitive 
to truthfulness and fidelity in others. They rarely for- 
give an injury and as seldom betray insensibility to kind- 
ness and indulgence. Once deceived by a nurse or atten- 



40 

dant, they never a second time bestow their confidence 
upon the same individual. 

Moderate employment, moderate exercise, as much free- 
dom as is consistent with the safety of the patient, and as 
little apparent anxious watchfulness, with cheerful so- 
ciety should be sought. The condition of the patients 
must determine the number of nurses in a ward. The 
general opinion is holden that all patients do better with- 
out special nurses, wholly devoted to their care. 

•'The proper mental and physical employment of the 
insane," says Dr. Kirkbride, " is of so much importance 
that the full treatment of this subject would be to give 
at once a treatise on the insane and ou insanity. What- 
ever it maybe, it must embrace utility, and it is well to 
combine both physical and mental occupation. Active 
exercise in the open air, moderate labor in the gardens, 
pleasure grounds, or upon the farm, afford good results. 
Short excursions, resort to the work shops, carpentering, 
joining, turning, the use of a good library &c. &c, are 
aids in advancing the cure of the patient." Sedentary 
employments are not in general favorable to health. 
The operations of agriculture seem liable to the least 
objection. There is a limit to beobserved in the use of 
labor as a moral means; for there are always some pa- 
tients to whom it is decidedly injurious. This effect is 
manifested oftenest in recent cases. 

Or. Ray says that it is an error to suppose that the in- 
sane can labor as productively and as uniformly as the 
sane man. The working hours of a patient should sel- 
dom exceed six or seven per diem, and not seldom work 
is altogether intermitted. 

The manner in which labor exerts a beneficial in- 
fluence upen the insane mind differs no doubt in different 
forms of the disease. In highly excited patients the sur- 
plus nervous energy will be consumed, if no other way'is 
provided, in mischief and noise ; but let it be expended in 
useful labor, and although the work may not always be 
perfectly well done, yet the patient thinks it is, and ex- 
periences the gratification of having done what he be- 



41 

Sieves is a good thing, and consequently, so far as it goes 
it is beneficial. 

This sentiment of satisfaction in being useful, the 
guardian of the insane cannot too carefully watch over and 
loster, since it conducts to self-control and self-respect. 
Incurables who are able and willing to work, are much 
more contented and enjoy better health when employed. 
Even some of the most demented and idiots are 
found capable of doing something. A young man be- 
came a raving maniac, and in three months was convey- 
ed to the hospital, but was already declining into idiocy; 
soon complete imbecility supervened. He was classed 
with the idiots in the institution ; and considered as past 
hope of benefit or cure. One day he was observed to 
amuse himself with some rude coloring and odd figures 
upon the walls of his room. He was supplied with col- 
ours, brushes, and canvass, and soon commenced a por- 
trait : he was now roused, and eager to accomplish his 
new and attractive work. He was encouraged to renew 
and repeat his attempts, and finally his mind was 
restored to its early and rational condition. Thus, care- 
ful attention to the daily state of the patient, suggested 
a method of treatment which resulted in a decided cure. 
The diseased organs were suffered to rest and their re- 
cuperative energies recovered action. 

The physician of the hospital at Staunton, in a report 
of his institution, says, that during the past year, the 
men patients were chiefly emplo}'ed in cultivating the 
farm, working the garden, improving the gronuds, con- 
structing fences, cutting wood, and attending to stock. 
The women were engaged in sewing, knitting, spinning, 
and assisting in various departments of house-work, and 
other occupations and recreations suited to their sex. 

" A patient, insane for more than ten years, and be- 
3'ond hope of recovery, considered dangerous to the pub- 
lic safety, and therefore detained at a hospttal, converses 
incoherently and raves wildly, yet finds constant and pro- 
fitable employment upon the farm ; has charge of a 
stockof cattle and hogs and is scrupulously'faithful in the 
discharge of his duties. Instead of confinement in a 
county jail, from whence he was removed to the Hospi- 
tal, in a most filthy, and abject condition, at a cost of 
little less than three hundred dollars per annum, he is 
here a genteel, orderly, and industrious individual, cheer- 
ful, happy, and useful : his labor more than pays all his 
expenses, and supplies him with sufficient indigencies." 
6 






42 

Prichard, in a work on insanity, says that '*atthe Rich- 
mond Asylum, out of 217 patients, 130 were actively and 
usefully employed viz: 18 in gardening, 16 in spinning, 
12 in knitting, 18 in needlework, 12 in washing, 16 in 
carrying tools, white-washing the wards, tailoring and 
wearing ; and 12 were learning to read." 

The following table exhibits the results of productive 
labor last year upon the Bloomingdale Hospital farm near 
New York, 8 or 10 acres being only cultivated. 



Potatoes, 1952 bushels, 


900 bushels, sound, at $0 75 | 


675J 


00 




Sugar Beet, 


180 « 


» 


37J 


67 


50 






Blood Beet, 


100 " 


a 


50 


50 


JO 






Turnips, 


460 " 


u 


31$ 


143 


75 






Carrots, 


28 " 


a 


50 


14 


00 






Parsnips, 


120 « 


a 




60 


00 






Onions, 


45 « 


tt 


75 


67 


00 






Corn, 


150 " 


u 


37$ 


56 


25 






Egg Plant, 


20 " 


u 


50 


10 


00 






Radishes, 


125 « 


a 


1 00 


125 


00 






Beans, 


120 " 


ct 


50 


60 


00 






Peas, 


65 « 


ct 


75 


48 


75 






P unking, 


75 " 


ct 


37$ 


28 


12 






Squashes, 


130 " 


tt 


" 


48 


75 






Spinach, 


210 " 


ct 


75 


157 


50 






Asparagus, 


40 « 


ec 


3 00 


120 


00 






Tomatoes, 


140 " 


u 


50 


70 


00 






Cucumbers, 


100 « 


ec 


75 


75 


00 






Nasturtiums, 


1 « 


tt 


2 00 


2 


00 






Peppers, 


4 « 


(I 


75 


3 


00 






Rhubarb, 


52 « 


tt 


2 00 


104 


00 






Citron Melon, 


75 « 


tt 


10 


7 


50 






Celery, 


2500 heads, 


tt 


3 


75 


00 


1 




Cabbages, 


3000 !' 


It 


4 


120 


00 






Leeks, 


1000 « 


C( 


0£ 


5 


00 






Salsify, 


2000 « 


it 


1 00 


20 


00 






Lettuce, 


4000 " 


tt 


2 00 


80 


00 


1,293 


62 


Hay, 


40 tons, 


a 


10 00 


400 


00 






Pork, 


1296 pounds. 


e: 


6 


77 


76 






Butter, 


663 " 


a 


25 


165 


75 






Milk, 


4488 gallons, 


(C 


16 


718 


OS 






Eggs, 


30 -J 1 dozen, 


<! 


12$ 


37 


ss 






Poultry, 


150 lbs. 


C! 


6 


9 


00 
















I— 1,408 


47 


fruits. 








[ 




Apples, 


200 bushels^ 


IC 


50 


100 


' 






Pears, 


20 « 


(i 


1 00 


20 


-.,.. 






Cherries, 


150 " 


cc 


1 00 


150 


00 






Currants, 


25 " 


tt 


1 00 


25 


00} 




Peaches, 


15 « 


tt 


1 00 


15 


Ou 




Grapes, 


1200 pounds, 


tt 


6} 


75 


ooj- 




Strawberries, 


8 bushels, 


t. 


2 00 


16 


ooj 















— 


401 


00 


Tot*;, 












* OS 


09 



43 

The able and distinguished Superintendant of the 
Ehode Island Hospital writes, that "no form of labor ap- 
pears so well calculated to promote the comfort and res- 
toration of such patients as have had habits of employ- 
ment, as working on a farm, and no institution can fully 
accomplish these purposes without plenty of land, and at- 
tendants to assist in cultivation." All patients, whether 
men or women, whose minds have been cultivated, and 
who have had habits of active industry and employment, 
possess high advantages in chances of recovery from at- 
tacks of insanity, over thejignorant, the indolent, and the 
inert. So also those whose habits have been methodical, 
and temperate in eating and drinking, have better chances 
of permanent restoration than those who possess their 
opposites. 

The standard of sound health is elevated by the disuse 
of stimulating food, and of all intoxicating drinks ; and 
by avoiding the use of Tobacco in any forms. 

Stimulants even not inordinately used, excite to undue 
mental and physical action. It might seem that the Apos- 
tle of old. apart from the morale of life, had comprehend- 
ed animal physics when he exhorted brethren to adhere 
to "moderation in all things." 

•'We have a patient, writes the Superintendant of the 
Maryland Hospital, " who had for many months been in 
a state of profound depression from which no efforts on. 
our part could rouse him. He had repeatedly attempt- 
ed suicide. He was a farmer, and when well, was en- 
terprising, industrious, and devoted to the pursuit. He 
walked out to the hay-field, and after much persuasion, 
lie was induced to amuse himself by mowing a little. 
Finding hisjinterest in the work increase, he continued to 
ply the scythe for two hours with short intervals. He 
now became cheerful and communicative ; ate with ap- 
petite at dinner; after which he expressed a wish to re- 
turn to the hay-field, where he continued mowing until 
evening. This labor was followed by a night of profound 
and refreshing sleep. The next morning he hastened to 
the field, and from that time was seldom unemployed ; 
his convalescence was rapid, and in about four weeks he 
returned to his lamily entirely restored. Similar cases 
are of frequent occurrence. Of ninety nine men patients, 
forty-five are habitually employed in useful work : And 
of fifty-seven women patients, all save eleven are for a 
great part of the time employed in the halls, in the kitchen, 
she washing and the ironing rooms, or in mending and 



^repairing garments and house-linen, and various sorts of 
needle-work. Thirty-eight of the women, and fifty-five 
of the men have been habitual readers, and find great 
benefit and satisfaction in the use of the library; indeed 
several patients seem to owe their restoration to adopt- 
ing a regular course of reading and study. 

Jn our times, when knowledge is so widely diffiused, it 
seems almost superfluous to dwell upon the benefits of 
hospital treatment above all private and domestic man- 
agement. It cannot be questioned, that suppose know- 
ledge, experience, and all domestic arrangements favor- 
able, one might decide in favor of treatment for the insane 
in their own families. This, however, cannot be assured 
even when all the appliances wealth may procure are at 
command, and therefore all persons who are familiar 
with these subjects, do not hesitate in advocating Hospi- 
tal residence for the insane of all conditions in society, 
whether rich or poor, educated or ignorant. Some ob- 
ject that associations of a painful nature may dwell upon 
the recollection of the recovered patient. Whatever ap- 
parent force this idea may possess, it is a well establish- 
ed fact that patients rarely entertain other than pleasant 
and grateful memories of their residence in weli-regnla- 
ted Hospitals. When these are not well organized, an/] 
wisely and carefully conducted, no patient under any cir- 
cumstances should be sent to them. 

Jacobi affirms that "the magnitude of anticipated evils 
has been greatly exaggerated" ; "as regards these," he 
says, "I can positively affirm that of six hundred cases 
which I have had the opportunity of accurately exami- 
ning in this establishment, (that of Siegberg, in Ger- 
many) I have never witnessed a single one in which the 
patient sustained any material injury from his residence 
in the establishment as a lunatic asylum, or from an}' in- 
fluence exercised upon him by other patients. Such 
ideas only are true of badly ordered Hospitals and these 
may always be known from those of good organization. 
The time has gone by, thanks to Heaven, when the un- 
happy insane could be cast into mismanaged Hospital?, 
and, as too often is the case, left, in jails, and poor-houses, 
festering in heaps of filthy straw, chained to the walls of 
dark and dreary cells, unworthy of solicitude, and vic- 
tims of the idle and interested maxim-that insanity is an 
incurable disease, and that insane people are unconsci- 
ous of the treatment they receive, and the cruel miseries 
to which they are so needlessly subjected. Much has 
been done, but more, much more, remains to be accon« 



45 

plished for the relief of these sufferers, in our own United 
States, as in other countries. With a population rating 
at more than 22,000 000, our insane and idiots number 
at the lowest estimate 22,000 ; and not 4,000, at this lime 
have the advantages of appropriate care in well organ- 
ized hospitals, or comfortable situations adapted to their 
condition and circumstances elsewhere. 

In 1844, the number of inmates in the hospitals of En- 
gland and Wales was 11,272. Additional accommoda- 
tions have been called for and provided to a large extent. 
The oldest hospital founded in England is that of Beth- 
lem, which king Henry the VIII presented to the City of 
London, in 1547. 

There are twenty State hospitals, besides several in- 
corporated hospitals, for the treatment of the insane, in 
nineteen States of the Union, Virginia alone having two 
government State hospitals. The following is a correct 
list, omitting several small establishments conducted by 
private individuals, and several pretty extensive poor- 
house and prison departments. 

The first hospital for the insane in the United States 
was established in Philadelphia, as a department of the 
Penn Hospital, in the year 1752. This has been trans- 
ferred to a fine district near the village of Mantua, in 
the vicinity of Philadelphia, since 1S32 : number of pa> 
tients 1S8. 

The second institution recieving insane patients, and 
the first exclusively for their use, was at Williamsburg, 
Virginia, in 1773: number of patients 105. 

The third was the Friends' Hospital, at Frankfort, near 
Philadelphia, in 1817: number of patients 95. 

The next was the McLean Hospital, at Charlestown, 
(now Summerville,) in Massachusetts, in t! 18l8. This 
valuable institution is second to none in America. Num- 
ber of patients 180. 

Bloomingdale Hospital, near the city of New York, 
was established in 1S21 ; number of patients 146 : South 
Carolina Hospital, at Columbia, in 1S22 ; number of pa- 
tients 74: Conneticut Hospital at Hartford, patients 122 
and Kentucky Hospital at Lexington, patents 247, in 
1824. 

In 1845-46, the legislature of Kentucky passed a bill 
to' establish a second State institution in the Green Riv- 
er country. 

Virginia Western Hospital was opened at Staunton in 
1S2S ; number of patients 217. Massachusetts State 
Hospital, at Worcester, was opened in 1833, and enlarg- 



46 

ed in 1843 ; it has 370 patients. Maryland Hospital, at 
Baltimore, was founded in 1834; it has the present year 
109 patients. Vermont State Hospital, at Battleborough, 
was opened for patients in 1S37, and enlarged in 184G-'47; 
it has at present. 320 patients. New York City Hospital 
for the poor, on Blackwell's island, was occupied in 1838 ; 
it is now being considerably enlarged : above 400 pa- 
tients. 

Tennessee State Hospital, at Nashville, was opened in. 
1830. According to an act of the legislature the present 
year, this hospital is to be replaced by one of capacity to 
receive 250 patients. In the old hospital are 64 patients. 
Boston City Hospital for the indigent, which has 150 pa- 
tients, and Ohio State Hospital at Columbus, were se- 
verally opened in 1839. The latter has been considera- 
bly enlarged, and has now 329 patients. Maine State 
Hospital, at Augusta, 1S40; patients 130. New Hamp- 
shire State Hospital, at Concord, was opened in 1842. and 
has 100 patients. New York State Hospital, at Utica, 
was established in 1843, and has since been largely ex- 
tended, and has 000 patients. Mount Hope Hospital, near 
Baltimore, 1844-45; has 72 insane patients. Georgia 
has an institution for the insane at Milledgeville, and at 
present 12S patients. Rhode Island State Hospital open- 
ed, under the able direction of Dr. Ray, early in 1848. 
New Jersey State Hospital, at Trenton, 1848. Indiana State 
Hospital, at Indianapolis, will be opened in 1848. State Hos- 
pital of Illinois, at Jacksonville, will be occupied before 1849. 
The Lousiana. State Hospital will be occupied perhaps within a 
year. 

These institutions, liberally sustained as are most of them, can- 
not accommodate the insane population of the United States who 
require prompt remedial care. 

Such being the facts, one can hardly employ language too im- 
portunate, arguments too persuasive, to secure such increased 
accommodations for the Insane throughout the United States, but 
especially in those States in which no Hospitals have been eslab. 
lishea, as shall assure their sufficient care and protection; their 
remedial treatment so as to procure recovery when recovery is 
possible; and their safety and guardianship in all cases where 
the terrible calamity of incurability crowds them forever from 
all the bland affections, and social enjoyments of domestic and 
friendly association. 

As ye would that others should do for you in like circumstan- 
ces, so do ye for these helpless ones, cast through the Providence 
of God, on your sympathy and care ! Be the guardians and ben- 
efactors of those, who as a writer in the 17th century finely ex- 



47 

presses himself, M are a particular rent charge upon the great 
family of mankind; left by the maker of us all like younger 
children, who though the Estate be given from them, yet the 
Father expected the heir to take care of them I" 

To see the mind once brilliant, and in the exercise of fine 
energies, obscured and inert ; or if quickened to action, trans- 
formed from the consistent bearing of a being possessed of ration- 
al understanding to the fury of a demon, or to the raging of an 
untamed brute — this is fearful, this is truly to behold the drain- 
ing to the dregs the cup of bitterness ! Oh with what ready 
zeal, with what wisdom and humanity should not every one di- 
rect himself to prevent miseries which no skill can wholly heal, 
& of which no foresight nor prudence can prevent the recurrence. 

" Weep not pale moralist o'er desert plains, 
Strewed with the wreck of grandeur's mouldering fanes, 
Arches of triumph long with weeds o'ergrown, 
And regal cities — now the serpent's own ; — 
Earth has more dreadful ruins, — one lost mind, 
Whose star is quenched, has lessons for mankind 
Of deeper import than each prostrate dome 
Mingling its marble with the dust of Rome" ! 

Bereft of reason, man loses every thing that renders 
life valuable. Naturally endowed with capacities for 
the highest enjoyment, he is suddenly through an attack 
of insanity, disabled from partaking the rational pleas- 
ures of life, and <*f exercising his noble faculties for his 
benefit or for the good of society. 

Though plunged in the most profound grief, — assailed 
by every form of trial and misfortune, while reason is 
spared, hope may cheer his dreary hours, — and faith 
support him through every trouble ; but dethrone reason 
and he is utterly prostrate. The merest infant is not 
more dependant on parental care, than is the maniac 
upon the tender ministrations of kindred or of friends. 
In an hour he becomes the beneficiary of humanity : the 
helpless ward of his fellow-men : him must nursing, and 
watching, and skilfulj cares surround, else is he the 
most pitiable of human beings — out-cast and forlorn — 
smitten of a terrible malady, exposed to sufferings, and 
woes, and tortures of which no language however vigo- 
rously^eombined can be the representation. Have pity up- 
on him, have pity upon him for the hand of God hath smit- 
ten him ! Talk not of expense — of the cost of support- 
ing and ministering remedies for these afflicted ones. 
Who shall dare compute in dollars and cents the worth 
of one mind ! Who will weigh gold against the price- 
less possession of a sound understanding ? You turn not 
away from the beggar at your door, ready to perish : 



48 

you open your hand, and he is warmed, and fed, and 
clothed : will } T ou refuse to the maniac the solace of a 
decent shelter, the protection of a fit asylum, the cares 
that shall raise him from the condition of the brute, 
and the healing remedies that shall re-illume the temple 
of reason ? Who amongst you is so strong that he may 
riot become weak ? Whose reason so sound that mad- 
ness may not overwhelm in an hour the noblest intellect? 

You will not, Legislators of North Carolina — Senators and Representatives 
of a noble State, you will not forget amidst the heat of debate, the clash of 
opinion, and the strife for political snpremacy ; you will not forget the ma- 
jesty of your station, the dignity of that -trust confided to you by the suf- 
frages of your fellow-citizens. 

It is not often that you are solicited to exercise your functions in behalf of 
the unfortunate. That you possess the power, and now the opportunity of 
exercising a gracious, benignant, and God-like influence upon the present 
and future destiny of hundreds, nay of thousands, who pine in want and 
misery, under privations and sufferings, wearily borne through heavy months 
and years — the light of whose reason is quenched, and whose judgment is a9 
the stubble upon a waste field ; this it is believed is a sufficient argument to 
determine your decisions in favor of justice, and of humanity, and of un- 
questionable civil obligation. 

As benefactors of the distressed whose mental darkness may, through your 
agency, be dispersed, how many blessings and prayers from gratefnl hearts 
will enrich you ! As your last hours shall be slowly numbered, and the re- 
view of life becomes more and more searching, amidst the shades of uncom- 
promising memories, how beautiful will be the remembrance that of the ma- 
ny of this life's transactions, oftenest controlling txfensient and outward af- 
fairs, frequently conducting to disquieting results, and sometimes to those of 
doubtful good, you have aided to accomplish a work whose results of wide- 
diffused benefits are as sanctifiying as they are permanent: blessing through all 
Time — consecrating through all Eternity ! 

Gentlemen, the sum of the plea of your Memoralist is embodied in the so- 
licitation for an adequate appropriation for the construction of a Hospital for 
the remedial treatment of the Insane in the State of North Carolina. 

Respectfully submitted, 

D. L. DIX. 

Raleigh, November, 1848. 






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